OBJECTIVE: A previous study in piglets with experimental pneumonia showed that reducing atelectasis by means of open lung ventilation attenuated bacterial translocation compared to conventional ventilation settings. This study examined the effect of open lung ventilation with higher than necessary positive end-expiratory pressures (PEEP) on bacterial translocation. DESIGN AND SETTING: Prospective animal study in a university-affiliated research laboratory. SUBJECTS: Thirty piglets. INTERVENTIONS: Animals were surfactant-depleted by whole-lung lavage and infected with group B streptococci. Thereafter the animals were ventilated for 5 h according to either a conventional ventilation strategy, open lung strategy, or open lung/high-PEEP strategy. Blood samples for blood gas analysis and blood bacterial counts were taken every hour. After 5 h of ventilation surviving animals were killed, and lung colony forming units and lung mechanics parameters were determined. RESULTS: All animals in both open lung groups survived but only 30% of those in the conventional ventilation group. Open lung ventilation resulted in significantly less bacterial translocation than either conventional or high-PEEP ventilation. Lung function in the conventional ventilated group was significantly less than in the two open lung groups. CONCLUSIONS: The lowest level of bacterial translocation was observed during optimal ventilation (open lung) which was achieved by using individually tailored settings. Deviation to either side can be harmful, as shown by the increased bacterial translocation during conventional and high-PEEP ventilation.
OBJECTIVE: A previous study in piglets with experimental pneumonia showed that reducing atelectasis by means of open lung ventilation attenuated bacterial translocation compared to conventional ventilation settings. This study examined the effect of open lung ventilation with higher than necessary positive end-expiratory pressures (PEEP) on bacterial translocation. DESIGN AND SETTING: Prospective animal study in a university-affiliated research laboratory. SUBJECTS: Thirty piglets. INTERVENTIONS: Animals were surfactant-depleted by whole-lung lavage and infected with group B streptococci. Thereafter the animals were ventilated for 5 h according to either a conventional ventilation strategy, open lung strategy, or open lung/high-PEEP strategy. Blood samples for blood gas analysis and blood bacterial counts were taken every hour. After 5 h of ventilation surviving animals were killed, and lung colony forming units and lung mechanics parameters were determined. RESULTS: All animals in both open lung groups survived but only 30% of those in the conventional ventilation group. Open lung ventilation resulted in significantly less bacterial translocation than either conventional or high-PEEP ventilation. Lung function in the conventional ventilated group was significantly less than in the two open lung groups. CONCLUSIONS: The lowest level of bacterial translocation was observed during optimal ventilation (open lung) which was achieved by using individually tailored settings. Deviation to either side can be harmful, as shown by the increased bacterial translocation during conventional and high-PEEP ventilation.
Authors: Anton H van Kaam; Robert A Lachmann; Egbert Herting; Anne De Jaegere; Freek van Iwaarden; L Arnold Noorduyn; Joke H Kok; Jack J Haitsma; Burkhard Lachmann Journal: Am J Respir Crit Care Med Date: 2004-02-20 Impact factor: 21.405
Authors: M J Bonten; A H Froon; C A Gaillard; J W Greve; P W de Leeuw; M Drent; E E Stobberingh; W A Buurman Journal: Am J Respir Crit Care Med Date: 1997-10 Impact factor: 21.405
Authors: Roy G Brower; Paul N Lanken; Neil MacIntyre; Michael A Matthay; Alan Morris; Marek Ancukiewicz; David Schoenfeld; B Taylor Thompson Journal: N Engl J Med Date: 2004-07-22 Impact factor: 91.245
Authors: J L Vincent; D J Bihari; P M Suter; H A Bruining; J White; M H Nicolas-Chanoin; M Wolff; R C Spencer; M Hemmer Journal: JAMA Date: 1995 Aug 23-30 Impact factor: 56.272
Authors: Vito Fanelli; Valeria Puntorieri; Barbara Assenzio; Erica L Martin; Vincenzo Elia; Martino Bosco; Luisa Delsedime; Lorenzo Del Sorbo; Andrea Ferrari; Stefano Italiano; Alessandra Ghigo; Arthur S Slutsky; Emilio Hirsch; V Marco Ranieri Journal: Intensive Care Med Date: 2010-08-19 Impact factor: 17.440
Authors: P M Spieth; A Güldner; A R Carvalho; M Kasper; P Pelosi; S Uhlig; T Koch; M Gama de Abreu Journal: Br J Anaesth Date: 2011-06-07 Impact factor: 11.719
Authors: María Elisa Quilez; Raquel Rodríguez-González; Marc Turon; Sol Fernandez-Gonzalo; Jesús Villar; Robert M Kacmarek; Ma Nieves Gómez; Joan Carles Oliva; Lluís Blanch; Josefina López-Aguilar Journal: Shock Date: 2015-12 Impact factor: 3.454
Authors: Raquel F de Magalhães; Cynthia S Samary; Raquel S Santos; Milena V de Oliveira; Nazareth N Rocha; Cintia L Santos; Jamil Kitoko; Carlos A M Silva; Caroline L Hildebrandt; Cassiano F Goncalves-de-Albuquerque; Adriana R Silva; Hugo C Faria-Neto; Vanessa Martins; Vera L Capelozzi; Robert Huhle; Marcelo M Morales; Priscilla Olsen; Paolo Pelosi; Marcelo Gama de Abreu; Patricia R M Rocco; Pedro L Silva Journal: Respir Res Date: 2016-11-25
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Johan Groeneveld; Goran Hedenstierna; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Philipp Metnitz; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2008-01-04 Impact factor: 17.440
Authors: Kristian Hellenkamp; Sabrina Onimischewski; Jochen Kruppa; Martin Faßhauer; Alexander Becker; Helmut Eiffert; Mark Hünlich; Gerd Hasenfuß; Rolf Wachter Journal: Crit Care Date: 2016-02-01 Impact factor: 9.097